Provider Demographics
NPI:1477501724
Name:WEINGARDEN, GARY I (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:I
Last Name:WEINGARDEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:16980 DALLAS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1974
Mailing Address - Country:US
Mailing Address - Phone:972-699-3508
Mailing Address - Fax:972-699-8281
Practice Address - Street 1:399 W CAMPBELL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3595
Practice Address - Country:US
Practice Address - Phone:972-699-3508
Practice Address - Fax:972-699-8281
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2013-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG2242207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133988905Medicaid
TX133988905Medicaid
TX85G115Medicare PIN